Instructions for home exercise may improve range of motion and strength prior to returning to normal activity. Once the cast is removed, the patient may need to limit activity for one to two more weeks before returning to sports. An X-ray sometimes taken at follow-up, but it is usually normal. The patient may bear weight if tolerated, with pain as the guide. If the fracture is stable, your child is usually placed in a walking cast or boot for about three to four weeks, or until the injury has healed.
If the fracture is through the growth plate, X-rays are often normal, unless the fracture is displaced. There is pain, swelling and often times bruising around the ankle that may extend to the foot bearing weight may be painful. The injury may occur when twisting, turning or rolling the ankle. This fracture occurs on the outside bone of the ankle.
It is much better to place your child in a cast / splint for protection than to assume it is "just a sprain." Closed Treatment of a Distal Fibular Fracture (Ankle) At this time, signs of healing may be evident, confirming the suspicion of a fracture. Your child may or may not need X-rays once the cast is removed. If your child is tender, has swelling or bruising and a history of an injury to this part of the body, he or she most likely will be placed in a cast or splint for about four weeks. You may ask the physician to "show you" the fracture however, sometimes the X-rays look normal and a fracture line cannot be seen. If the bone broke in this area but did not move or displace, the X-rays may appear normal. Growth plate fractures occur through the growth plate. Most fractures are treated with casting, splinting or immobilization of some type. The doctor will advise you which option is best for the patient. Some injuries require surgery - pins, plates or screws may have to be placed. This is often done under sedation in the Emergency Department. If the fracture is displaced, the doctor may need to improve the alignment through manipulation of the fracture. Most often the fracture is treated with casting. This may require follow-up X-rays for up to two years after the original fracture. In addition, X-rays are used to follow the healing of the fracture and to detect any growth abnormalities as they occur. X-rays can determine what pattern the child has. There are five different patterns of growth plate injuries - each may have a different prognosis. Sprains are extremely rare in young children. If the child is tender over the area of the growth plate or bone, the doctor will treat for a growth plate injury or an occult fracture. This can cause confusion for parents and patients. Sometimes the initial X-rays will not show a fracture even when one is present.
X-rays will often show if a fracture involves the growth plate. The doctor will tell you if the fracture involves the growth plate and if there is a potential growth plate problem, which depends on the type and site of the injury. The good news is that although fractures often involve the growth plate, rarely is it a problem. Occasionally there can be a disturbance of the normal growth resulting in a bone shortening or angulation.
The growth plate is a very active region of the bone and represents the location of continued growth of that individual bone. If the fracture involves the ends of the bone, the growth plate may be involved. A fracture in a child can be very different from a fracture in the same location in an adult.
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